Exercise Self-efficacy Scores Research Articles

Motivation for physical activity in the Jordanian military: Possible determinants of physical activity in male and female recruits

ABSTRACT Given the obligatory nature of physical fitness training in the military and in order to guide intervention development, our study assessed possible motivational determinants as suggested by self-determination theory in addition to other possible determinants. A cross-sectional study was conducted among 218 military recruits during their basic training in Jordan. Physical activity and lifestyle behaviors were measured using the Arab Teens Lifestyle Study (ATLS). Psychosocial variables were assessed using the Exercise Self-Efficacy Scale (ESE), Behavioral Regulation Exercise Scale (BREQ-2) and Exercise Benefits/Barriers Scale (EBBS). Bivariate correlation analysis revealed that identified self-regulation, introjected regulation and exercise self-efficacy scores were positively associated with higher Metabolic Equivalent of Task (METs) and minutes per week of physical activity among male recruits and the overall sample respectively. Among females, only external regulation was positively associated with the total METs/week. Being a male was significantly associated with higher minutes of physical activity among the overall sample. Multivariate regression analyses showed that identified regulation was significantly and positively associated with higher minutes of physical activity among the overall sample and male recruits in addition to higher METs per week among the male recruits. Also, the amotivation score was significantly and positively associated with higher minutes of physical activity among the overall sample and male recruits. A multivariate regression analysis for female recruits showed no significant associations. Intervention developers are advised to increase autonomous forms of motivation through structured enjoyable physical fitness programs in order to enhance intrinsic motivation in the long term.

Exploring the Interrelationships Between Physical Function, Functional Exercise Capacity, and Exercise Self-Efficacy in Persons Living with HIV.

To determine if there were differences between the subjective and objective assessments of physical activity while controlling for sociodemographic, anthropometric, and clinical characteristics. A total of 810 participants across eight sites located in three countries. Subjective instruments were the two subscales of Self-efficacy for Exercise Behaviors Scale: Making Time for Exercise and Resisting Relapse and Patient-Reported Outcomes Measurement Information System, which measured physical function. The objective measure of functional exercise capacity was the 6-minute Walk Test. Both univariate and multivariant analyses were used. Physical function was significantly associated with Making Time for Exercise (β = 1.76, p = .039) but not with Resisting Relapse (β = 1.16, p = .168). Age (β = -1.88, p = .001), being employed (β = 16.19, p < .001) and race (βs = 13.84-31.98, p < .001), hip-waist ratio (β = -2.18, p < .001), and comorbidities (β = 7.31, p < .001) were significant predictors of physical functioning. The model predicting physical function accounted for a large amount of variance (adjusted R2 = .938). The patterns of results predicting functional exercise capacity were similar. Making Time for Exercise self-efficacy scores significantly predicted functional exercise capacity (β = 0.14, p = .029), and Resisting Relapse scores again did not (β = -0.10, p = .120). Among the covariates, age (β = -0.16, p < .001), gender (β = -0.43, p < .001), education (β = 0.08, p = .026), and hip-waist ratio (β = 0.09, p = .034) were significant. This model did not account for much of the overall variance in the data (adjusted R2 = .081). We found a modest significant relationship between physical function and functional exercise capacity (r = 0.27). Making Time for Exercise Self-efficacy was more significant than Resisting Relapse for both physical function and functional exercise capacity. Interventions to promote achievement of physical activity need to use multiple measurement strategies.

An observational study of personal and environmental factors associated with attendance at a community-based adaptive fitness center for adults with physical disabilities

BackgroundRegular exercise has many benefits for adults with physical disabilities (AwPD). Despite these benefits, significant barriers to participating in exercise exist for AwPD. Community-based adaptive fitness centers promote exercise for AwPD by minimizing barriers. Research has yet to clearly examine the personal and environmental factors associated with enrollment and attendance rates of AwPD in community-based adaptive fitness centers. ObjectiveThe purpose of our study was to explore personal and environmental factors associated with AwPD and their attendance at a community-based adaptive fitness center once enrolled. MethodsIndividuals aged 18–85 with a physical disability interested in exercising were referred to a community-based adaptive fitness center. At initial assessment, participants completed demographics, health, barriers to exercise, and exercise self-efficacy (ESE) surveys. Following initial assessment, participant visits to the fitness center were tracked for six months. ResultsOf 106 participants, 27 never visited the facility after initial assessment, and the remaining participants with six months of attendance data (n = 67) averaged 14.9 (SD = 14.2) visits. Correlation results showed a negative curvilinear relationship between number of visits and years living with disability (rs = −0.24, p < 0.05), with higher attendance associated with more recent diagnosis. Logistic and stepwise regressions showed that ESE score (β = 0.107, p = 0.026) was the only significant predictor of attending the fitness center once enrolled. ConclusionsThis study demonstrates the importance of understanding personal and environmental factors and assessing ESE for AwPD who are newly enrolled in a community-based adaptive fitness center.

Predictors of poor exercise self-efficacy improvements after cardiac rehabilitation

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): SOLVE-CHD Australian Government National Health and Medical Research Council (NHMRC) Synergy Grant [GNT1182301] PhD Scholarships Background/Introduction Building confidence to exercise regularly (exercise self-efficacy (ESE)) in the face of constraints and barriers, is a key goal of cardiac rehabilitation (CR) because such self-efficacy beliefs are predictors of sustained exercise behaviours. Therefore, identifying patient subgroups at risk of poor ESE enables tailoring of CR and appropriate targeting of support interventions. Purpose To identify independent predictors of poor ESE and poor improvements in ESE in CR participants. Methods The study used a prospective observational cohort design and recruited patients with coronary heart disease at CR entry across four sites in Metropolitan Sydney, Australia (2019-2020). Data were also compared for traditional in-person and remote-delivered CR during COVID-19 pandemic restrictions. The Exercise Self Efficacy Scale was used to measure ESE at CR entry and completion, and General Linear Models were used for analyses. Results Participants (n=194) had a mean age of 65.94 (SD 10.46) years, with 80.9% males; and 80.0% were married or partnered, with 23.6% from an ethnic minority background. Referral diagnosis included elective percutaneous coronary intervention (PCI) (40.2%), coronary artery bypass surgery (26.3%), and myocardial infarction with or without PCI (33.5%). At CR entry, the mean ESE score was 24.93 (SD 5.99) points, which improved significantly by completion (p=.027). The GLM of ESE change (Adjusted R2=.247) identified that predictors of less change in ESE scores by CR completion included ethnic minorities (β=2.96, p=.003), not having a spouse or an intimate partner (β=-2.42, p=.023), and attending in-person CR (β=1.75, p=.036). Having higher ESE scores at entry was also associated with less ESE change on completion, such that for every point increase in ESE at entry, there was a reduction of .37 points in change (p&amp;lt;.001). These variables were also the same predictors of poor ESE at CR completion. Conclusions Confidence to exercise improves in CR, and screening for ESE at CR entry enables identification of patients at-risk of poor improvements. Tailoring of interventions to provide appropriate support such as extending CR should be considered for patients from ethnic minorities and those who are single/widowed. Exploring the reasons for differences in outcomes from in-person and remote-delivered CR using appropriate methods should be the focus of future research.

Exploration of the feasibility to combine patients with chronic obstructive pulmonary disease and chronic heart failure in self-management groups with focus on exercise self-efficacy

Objective To compare the level of exercise self-efficacy, symptoms, functional capacity and health status and investigate the association between these variables in patients with chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF). Additionally, to investigate how diagnosis, symptoms and patient characteristics are associated with exercise self-efficacy in these patient groups. Design Cross-sectional study. Setting Primary care. Subjects Patients (n = 150) with COPD (n = 60), CHF (n = 60) and a double diagnosis (n = 30). Main outcome measures Swedish SCI Exercise Self-Efficacy score, modified Medical Research Council Dyspnea score (mMRC), fatigue score, pain severity score, Hospital Anxiety and Depression Scale, functional capacity measured as six-minute walking distance and health status measured by a Visual Analogue Scale. Results Levels of exercise self-efficacy, health status and symptoms were alike for patients with COPD and patients with CHF. Functional capacity was similar after correction for age. Associations with exercise self-efficacy were found for slight dyspnea (mMRC = 1) (R −4.45; 95% CI −8.41– −0.50), moderate dyspnea (mMRC = 2) (−6.60;−10.68– −2.52), severe dyspnea (mMRC ≥ 3) (−9.94; −15.07– −4.80), fatigue (−0.87;−1.41– −0.32), moderate pain (−3.87;−7.52– −0.21) and severe pain (−5.32;−10.13– −0.52), symptoms of depression (−0.98;−1.42– −0.55) and anxiety (−0.65;−0,10– −0.32), after adjustment for diagnosis, sex and age. Conclusion and implications Patients with COPD or CHF have similar levels of exercise self-efficacy, symptoms, functional capacity and health status. More severe symptoms are associated with lower levels of exercise self-efficacy regardless of diagnosis, sex and age. When forming self-management groups with a focus on exercise self-efficacy, it seems more relevant to consider level of symptoms than the specific diagnosis of COPD or CHF. Key points Exercise training is an important part of self-management in patients with COPD and chronic heart failure (CHF). High exercise self-efficacy is required for optimal exercise training. Patients with COPD and CHF have similar symptoms and similar levels of exercise self-efficacy, functional capacity and health status. Not the diagnosis, but symptoms of dyspnea, fatigue, pain, depression and anxiety are important factors influencing exercise self-efficacy and need to be addressed. When forming self-management groups with a focus on exercise self-efficacy, it seems more relevant to consider the level of symptoms than the specific diagnosis of COPD or CHF.

Ergenler Arasında Fiziksel Aktivite, Egzersiz Öz-Yeterlilik Düzeyi ve Davranış Değişikliği Aşamalarının Değerlendirilmesi

Objective: This study aims to assess the level of physical activity, exercise self-efficacy, and the stages of change for exercise behavior among adolescents.Materials and Methods: This research was conducted as descriptive. The study population consisted of 529 students attending at a high school. No sample selection method was used. The whole of the population was tried to be reached and the study was carried out with 500 students. The data for the study were collected using a personal information questionnaire, the Exercise Self-efficacy Scale Questionnaire, the Exercise Stages of Change Short Form and International Physical Activity Questionnaire-Short Form.Results: The study found that 37,6% of the adolescents were physically active at a moderate level and 36,4% were in the pre-contemplation stage of exercise change phases. The mean exercise self-efficacy score among the adolescents was moderate (13,64±6,06). Data analysis showed that as the physical activity levels of adolescents increased, their exercise self-efficacy scores increased.Conclusion: It was found that exercise self-efficacy scores of adolescents increased as both exercise change stages and physical activity levels increased. It is recommended to provide training for adolescents in order to make their conditions suitable for physical activity, to provide appropriate time and to increase the desire of young people in this regard. It is recommended that the trainings be conducted taking into account the stages of change adolescents are in.

Gender Differences and Their Influences on T2DM Self-Management Among Spanish-Speaking Latinx Immigrants.

Evidence suggests that gender may influence many aspects of type 2 diabetes (T2DM) self-management (SM) and we posit that limited English language-proficient Latinx immigrants face additional challenges. Instruments and semi-structured interviews were used to examine gender differences on health literacy, diabetes knowledge, health-promoting behaviors, diabetes, eating and exercise self-efficacy (SE), and T2DM SM practices among a cohort of limited English language-proficient Latinx immigrants. Statistical and qualitative analysis procedures were performed comparing males and females. Thirty persons participated. Males tended to be older, have higher educational achievement, and more financial security than females. Physiologic measures tended worse among female participants. Health literacy and exercise SE scores were similar, but females scored lower on Eating and Diabetes SE. Forty-seven percent (n= 9) of the women reported a history of gestational diabetes mellitus and a majority of men (n = 7) cited difficulty with excessive alcohol. Males appeared to receive more SM support compared to females. Females more frequently noted how family obligations and a lack of support impeded their SM. Work environments negatively influenced SM practices. Men and women have unique SM challenges and as such require individualized strategies and support to improve T2DM management.

Determinants of physical activity level of people living in rural areas according to the transtheoretical model: regression and path analysis.

This study investigates the relationship between the physical activities of adults living in rural areas and each component of the Transtheoretical Model. This descriptive and relational study was conducted with 315 individuals at a rural clinic in Turkey. Data were collected using tools for evaluating the Transtheoretical Model, and the International Physical Activity Questionnaire. Logistic regression analysis, multiple regression analysis, and path analysis were used in statistical analyses. Of the individuals living in rural areas, 59.1% were inactive, and 42.4% of the individuals were in the precontemplation stage. The mean exercise self-efficacy score was low, and pros subdimension of decisional balance was at an insufficient level. According to path analysis, perceived self-efficacy and stage of change for exercise were the variables that had a significant effect on physical activity (the metabolic equivalent of task score). The Transtheoretical Model is a strategic approach to improving exercise behavior in rural areas, and the prerequisites of health promotion such as enhancing education, income, and opportunities will contribute to the popularization of exercise.

Identification of Distinct Profiles of Cancer-Related Fatigue and Associated Risk Factors for Breast Cancer Patients Undergoing Chemotherapy: A Latent Class Analysis.

Cancer-related fatigue is a complex, multidimensional, subjective experience that affects patients physically, emotionally, and mentally. The interindividual variability in symptoms of cancer-related fatigue merits further exploration. Our objective was to identify distinct profiles of cancer-related fatigue experienced by breast cancer patients undergoing chemotherapy and to evaluate how subgroups vary demographically in clinical characteristics and in modifiable factors such as physical activity, sleep quality, and exercise self-efficacy. Fatigue was assessed with the Chinese Cancer-Related Fatigue Scale, and a latent class analysis was performed to identify subgroups of patients with distinct fatigue profiles. A total of 427 breast cancer patients were included in the data analyses. Five different fatigue profiles were identified: all low-risk fatigue, all high-risk fatigue, high-risk physical fatigue, high-risk emotional fatigue, and high-risk mental fatigue. Patients in different subgroups were characterized by different risk factors. For example, patients in the high-risk emotional fatigue group had less education, lower monthly household incomes, lower exercise self-efficacy scores, less sedentary behavior, poorer sleep, and poorer quality-of-life outcomes compared with those in the all low-risk fatigue group. These findings reveal that breast cancer patients undergoing chemotherapy show significant heterogeneity in their experience of cancer-related fatigue. Characteristics associated with different fatigue profiles, in particular the high-risk profiles, can be used by clinicians to target patients at greater risk of poorer symptom and quality-of-life outcomes to provide interventions tailored to their different needs.

Enhancing Psychosocial Constructs Associated with Technology-Based Physical Activity: A Randomized Trial Among African American Women

ABSTRACTBackground: Minority women have demonstrated higher rates of health disparities associated with lower levels of physical activity, a finding prevalent among college-aged individuals. Though these health disparities occur given a variety of factors, novel, technology-based interventions are being developed to increase physical activity, with Social Cognitive Theory (SCT) serving as a useful framework for guiding such interventions. Purpose: This investigation sought to evaluate 2 technology-based interventions on physical activity motivation and psychosocial variables among young African American women. Methods: Forty-nine female African American college students aged 18–24 used an UpBand accelerometer and app or a diet tracker app for 6 weeks. Posttesting occurred at the conclusion of the intervention and 2 months postintervention. Results: Perceived family support for exercise decreased in both groups, F(2, 94) = 9.90, P < .001, partial η2 = 0.17. Following an initial decrease in exercise self-efficacy scores from pre- to posttest, an increase in exercise self-efficacy was evidenced from posttest to the 2-month follow-up for both groups, F(1, 47) = 10.90, P = .002, partial η2 = 0.188. Discussion: Although technology-based physical activity apps include social constructs, this study did not find strong support for promoting the psychosocial variables among participants. The use of fitness-promoting technology may facilitate exercise self-efficacy in minority female college students. Translation to Health Education Practice: Technology-based interventions may be more effective when used in conjunction with traditional physical activity promotion.

The feasibility of an exercise program 12 months post-stroke in a small urban community.

There are few community-based exercise programs catering to individuals post-stroke, despite an increasing need. The primary objective of this study was to assess the feasibility of running a community-based exercise program for individuals post-stroke, and to provide a framework for local communities to run similar programs. Individuals who had a stroke within 12 months of the start of the program were eligible to participate in a 9-week community-based exercise program. Sit to stand, grip strength, arm curl, timed up-and-go, 6-minute walk, Berg Balance Scale, Stroke-Specific Quality of Life Questionnaire, and Exercise Self-Efficacy Scale were assessed pre- and post-program to determine the effectiveness of the program. Caregivers of participants were invited to participate in a focus group after the program (N.=5) to better understand program feasibility and areas for improvement. Individuals (9 males, 1 female) with stroke were recruited from a local rehabilitation program within 1 week (aged 72.7±9.3 years). The ratio of volunteers to participants was 1:2. All participants completed the exercise program and pre-post-testing. Significant improvements were observed for sit to stand (7.6±3.4 to 9.8±4.3 repetitions, P<0.01), grip strength of the non-affected side (29.7±8.9 to 32.6±8.3 lbs, P=0.04), arm curl (15.2±6.1 to 19.9±4.7 repetitions, P=0.04), and Exercise Self-Efficacy score (Z=2.50, P=0.01, r=0.79) from pre to post-program. Caregivers suggested increasing the frequency of the program. An effective community-based exercise program for individuals post-stroke can be run at community centers utilizing qualified volunteers.

The Effects of a Program Combining Exercise and Music on Promoting Exercise Continuance and Psychological Factors in Older People

Physical exercise can have a positive effect on physical and cognitive functions in older people. However, the elderly often face difficulties in maintaining exercise routines. Music is reported to effectively improve the subjective experience of physical exercise’s intensity, execution, and enhanced capacity related to a sense of accomplishment. We aimed to investigate whether adding music to physical exercise promoted exercise continuance compared with physical exercise alone. The participants were 74 community-dwelling older people who independently maintained activities of daily living. They were either assigned to a music group (MG) or non-music group (NMG). Exercise classes were held once a week for 3 months. The number of times participants participated in the exercise classes, and the number of times they performed exercises at home was assessed. In addition, each participant completed a set of questionnaires assessing exercise self-efficacy (SE) and quality of life before and immediately after the 3-month intervention. After the 3-month intervention, the MG had a significantly higher frequency of participation in the exercise classes and a significantly higher exercise SE score compared with the NMG. Our results show that the combination of physical exercise and music was beneficial for exercise continuance and exercise SE compared with physical exercise alone. Keywords: music, exercise, continuance, exercise self-efficacy, independent older people.

Self-efficacy and Walking Performance in Persons With Multiple Sclerosis.

Impairment of walking function is a prevalent and burdensome feature of multiple sclerosis (MS), and represents a primary focus of rehabilitation research and clinical care. Research examining self-efficacy as a correlate of walking performance in MS is lacking; self-efficacy represents a theory-based, modifiable target of rehabilitation approaches for improving walking outcomes. This cross-sectional study examined the association between self-efficacy and walking performance in persons living with MS. The sample included 69 persons with MS who completed the Multiple Sclerosis Self-Efficacy (MSSE) Scale and Exercise Self-Efficacy (EXSE) Scale and undertook the Timed 25-Foot Walk (T25FW) and the 6-Minute Walk (6MW) tests. The data were analyzed using the Pearson product moment correlation coefficients and linear regression. Correlation analysis indicated that function subscale scores on the MSSE correlated more strongly with T25FW (r = 0.55) than did the control subscale (r = 0.40) and EXSE (r = 0.38) scores, and both function (r = 0.67) and control (r = 0.53) subscale scores on the MSSE correlated more strongly with 6MW than did EXSE scores (r = 0.40). Linear regression analyses indicated that (1) function MSSE subscale, but not control subscale, explained significant variance in T25FW speed and 6MW distance and (2) function MSSE subscale, but not EXSE, explained significant variance in T25FW speed and 6MW distance. We provide the first evidence of an association between self-efficacy, particularly for functioning with MS, and objective walking performance in MS. Future research to replicate and extend these results can inform rehabilitation efforts that target improvement of walking performance in persons with MS.Digital Abstract available for more insights from the authors (see Slides, Supplemental Digital Content 1, http://links.lww.com/JNPT/A171).

Receptivity and Preferences for Lifestyle Programs to Reduce Cancer Risk among Lung Cancer Family Members.

Lifestyle factors and genetic information has been found to contribute to the occurrence of lung cancer. This study assessed receptivity to participating in lifestyle programs to reduce cancer risk among unaffected lung cancer family members. We also explored demographic, medical, and psychosocial correlates of willingness to participate in lifestyle programs. Family members who are part of a lung Cancer Family Registry were asked to fill out a survey assessing their receptivity to cancer risk reduction programs including preferences for an individual or family-based program. Of the 583 respondents, 85% were "Somewhat" or "Definitely" willing to participate in a lifestyle program. Among those receptive, about half (56%) preferred a family-based approach. Preferred programs included weight management (36%) and nutritional information (30%). Preferred delivery channels were Internet (45%) and mail-based (29%) programs. On multivariate analysis, those definitely/somewhat receptive reported greater exercise self-efficacy scores (p=0.025). The majority of the sample was receptive to lifestyle programs that might decrease cancer risk. There was a large preference for family-based weight management and nutritional programs. Further research is indicated to determine how to best incorporate a family-based approach to lifestyle programs for cancer family members.

Effectiveness of a Releasing Exercise Program on Anxiety and Self-Efficacy Among Nurses.

The purpose of this study was to evaluate the effectiveness of a releasing exercise program (REP) on anxiety and exercise self-efficacy among nurses. The REP consisted of warm-up and tension-releasing exercises and mood adjustment. Ninety-nine nurses (age = 33.38 ± 7.38 years) experiencing anxiety (average Visual Analog Scale for Anxiety [VASA] score of 5.63 ± 1.44 at baseline) were randomly assigned to an experimental group (n = 50) that received 50-min REP sessions 3 times a week or a control group (n = 49) that did not attend REP sessions. The outcome measures were VASA, the Chinese Version of the Beck Anxiety Inventory, and Exercise Self-Efficacy Scale scores. At Weeks 12 and 24, the experimental group had significantly lower anxiety levels and higher exercise self-efficacy scores than the control group. Therefore, the REP effectively reduces anxiety and enhances self-confidence in exercise capability.

Testing the effectiveness of a self-efficacy based exercise intervention for inactive people with type 2 diabetes mellitus: design of a controlled clinical trial

BackgroundSufficient exercise is important for people with Type 2 Diabetes Mellitus (T2DM), as it can prevent future health problems. Despite, it is estimated that only 30-40% of people with T2DM are sufficiently active. One of the psychosocial constructs that is believed to influence physical activity behaviour, is exercise self-efficacy. The goal of this study is to evaluate a patient-tailored exercise intervention for people with T2DM that takes exercise self-efficacy into account.Methods/DesignThis study is conducted as a non-randomized controlled clinical trial. Patients are eligible when they are diagnosed with T2DM, exercise less than advised in the ADA guideline of 150 min/week of moderate-intensity aerobic physical activity, have an BMI >25 and are between 18 and 80 years old. Recruitment takes place at a Primary care organization of general practitioners and practice nurses in the south of the Netherlands.Participants are allocated to three groups: An advice intervention -for participants with a high exercise self-efficacy score- in which participants receive a patient-tailored exercise intervention, an intensive intervention -for participants with a low exercise self-efficacy score- in which participants receive a patient-tailored exercise intervention accomplished by a group based intervention, and a control group in which participants receive regular Dutch diabetes care. The primary outcome measure of this study is physical activity. Secondary outcome measures are health status, (symptoms of) depression, exercise self-efficacy, Body Mass Index (BMI), blood pressure and glycemic control.DiscussionWe aimed to design an intervention that can be implemented in Primary care, but also to design an easy accessible program. This study is innovative as it is -to our best knowledge- the first study that takes level of exercise self-efficacy of people with T2DM into account by means of giving extra support to those with the lowest exercise self-efficacy. If the program succeeds in increasing the amount of physical activity it can be implemented in regular primary care.Trial registrationDutch Trial Register NTR2734

The effect of an intervention combining self‐efficacy theory and pedometers on promoting physical activity among adolescents

To study the effect of an intervention combining self-efficacy theory and pedometers on promoting physical activity among adolescents. The beneficial effects of regular physical activity on health in youths are well-documented. However, adolescence is found to be the age of greatest decline in physical activity participation. Physical activity participation among girls was generally less frequent and less intense than boys. Therefore, there is a strong need for effective interventions that can help promote physical activity in this population. An experimental design. Two classes of female junior college students (mean age = 16) were randomly sampled from a total of four classes and, of those, one each was randomly assigned to either the intervention (n = 46) or the control group (n = 48). Self-efficacy was used as a core theoretical foundation of the intervention design, and pedometers were provided to the students in the intervention group. Distances between each domestic scenic spot were illustrated graphically in a walking log for students to mark the extent of their walking or running. Students in the control group participated in a usual physical education programme. The primary outcome was a change in the number of aerobic steps. The secondary outcomes were changes in cardiopulmonary endurance and exercise self-efficacy. At 12-week follow-up, the mean change in aerobic steps was 371 steps and 108 steps in the intervention and control group, respectively. The difference in mean change between the two groups was 467 steps. Effects of the intervention on changes of cardiopulmonary endurance and perceived exercise self-efficacy scores were not found. Among adolescent girls, a 12-week intervention designed on the theoretical foundation of self-efficacy theory and provision of pedometers was found to have an effect on increasing their physical activity. The intervention, using graphs of domestic scenic spots to represent the distance of walking or running as monitored by pedometers, might enhance motivation regarding physical activity. It is important for health professionals, including school health nurses, involved in the care of adolescent health, to design and provide a physical activity intervention combining self-efficacy theory and provision of pedometer to promote physical activity.

Effects of 12-month exercise on health-related quality of life: A randomized controlled trial

ObjectiveWe investigated exercise effects on health-related quality of life (HRQOL) and exercise self-efficacy, and tested effect modification by baseline body mass index (BMI) and gender. MethodsMiddle-aged women (n=100) and men (n=102) were randomly assigned to either exercise (360 min/week of moderate-to-vigorous aerobic exercise) or control in Seattle, WA, from 2001 to 2004. Demographics, anthropometrics, exercise self-efficacy (5-item self-efficacy questionnaire) and HRQOL (SF-36) were assessed at baseline and 12months. Analysis of covariance adjusting for baseline scores was used to compare HRQOL and exercise self-efficacy scores between the exercise and control groups. ResultsAt 12months, exercisers demonstrated higher exercise self-efficacy than controls (percent change from baseline: −6.5% vs. −15.0%, p<0.01), without differences in HRQOL. Baseline BMI category and gender did not modify these effects. In exploratory analyses comparing exercisers and controls within subgroups defined by gender and BMI, 12-month HRQOL scores [role–physical (+7.0% vs. −13.1%), vitality (+15.6% vs. −4.2%), social functioning (+10.0% vs. −3.5%), and mental health (+6.8% vs. −2.9%)] were higher only among overweight male exercisers (p<0.05, vs. control). ConclusionThree hundred and sixty minutes per week of exercise, recommended for weight maintenance, did not have negative effects on exercise self-efficacy or HRQOL. This level of exercise may increase HRQOL among overweight men.Trial registration. NCT00668161.

Factors Predicting Adherence To 9 Months Of Supervised Exercise In Healthy Older Women

The determinants of physical activity participation in older people have been well-documented. Less is known, however, about factors affecting adherence to highly-structured and supervised exercise programs. PURPOSE: To determine factors related to adherence to a 9-month exercise trial among previously-inactive, healthy older (> 65 y) women (N=30). METHODS: Subjects were randomized into a: 1) higher- (ATH - 80% VO2peak); or 2) moderate- (ATM - 65% VO2peak) intensity aerobic; or 3) lower-intensity resistance (RTL; 50% VO2peak) group. All three groups were identical in exercise frequency (4 days/week); however, subjects in the AT groups exercised for a duration necessary to expend 300 kcal/session. All sessions were supervised at on-site facilities and subjects exercised in groups to enhance convenience and social support. Heart rate was measured continuously and recorded throughout exercise. Attendance was defined as the proportion of completed to prescribed exercise sessions (N=144). Adherence was defined as the proportion of prescribed sessions in which subjects achieved their: 1) prescribed heart rate; and 2) their prescribed duration. Determinants of adherence included age, BMI, lean mass (kg), %body fat, VO2peak, prescribed intensity (METs) and prescribed duration (min), and exercise self-efficacy score. RESULTS: Age, VO2peak, and body composition were similar among the three groups. Attendance was greatest in the ATH group (94%) and lowest in ATM (90%). Adherence to the prescribed duration was 95%, 91%, and 85% in the RTL, ATH, and ATM groups, respectively. Adherence to the prescribed intensity was 100% for all three groups. We observed a positive (rather than inverse) correlation between the prescribed METs and attendance (r=0.48; p<0.03), as well as adherence to the prescribed duration (r=0.53; p<0.01). Prescribed duration was not associated with attendance (r=0.14; p<0.46); however, the prescribed duration of each session was the strongest determinant of adherence to that duration (r=-0.72; p<0.0001). CONCLUSIONS: Exercise duration (not intensity) may negatively affect adherence to structured exercise programs. Programs comprising exercise of shorter duration, but greater frequency may be more effective in helping older adults achieve the health benefits of an active lifestyle.

Evaluation Of A Simple Intervention To Increase Self-efficacy For Independent Exercise In Cardiac Rehabilitation Participants

While benefits of exercise after a cardiac event are well documented, participation in and adherence to cardiac rehabilitation (CR) programs is often low. PURPOSE: To test the effectiveness of a self-efficacy coaching intervention (SCI): a simple theory-based behavioral intervention to increase self-efficacy for independent exercise as well as independent exercise behavior in CR patients. It was hypothesized that persons receiving the SCI treatment (T) would have higher levels of self-efficacy for exercise and greater participation in independent exercise than those in an attention control (C) group. METHODS: People referred to a hospital-based CR program by their physician were invited to participate in the study (N = 65). Participants were assigned to either T or C groups which were randomly designated by class time. The SCI was administered every two weeks by CR staff as a supplement to standard CR care. Patients in the T group received coaching about independent exercise, patients in the C group received coaching matched for time and technique but covering information about healthy eating. Self-efficacy for independent exercise was assessed at the beginning and end of the supervised CR program with an Exercise Self-Efficacy (ESE) scale and a Barriers Self-Efficacy (BARSE) scale. Participation in independent exercise was determined by self-report with activity logs. Outcome differences between and within T and C groups were analyzed through one-way ANOVA. RESULTS: Differences between groups were not statistically significant (p >.10) for any outcome variable. Significant within groups changes (p <.05) were seen for BARSE change in the T group, and for independent exercise change in both groups. Analysis of covariance suggested an independent effect of gender on change in ESE and BARSE scores, and an independent effect of previous exercise on exercise change. CONCLUSIONS: This study adds to the limited body of knowledge about theory-based interventions in CR programs and takes an important step in translating self-efficacy theory into a simple, practical application that will promote maintenance of lifestyle changes in this population. Further study is needed to see if the changes translate into maintenance of independent exercise behavior after completion of a formal CR program.